Preface to the Fourth Edition | |
Introduction | |
Administration and Intake Forms | |
Introduction | |
Screening Information | |
Notice of Appointment | |
Consent to Treatment and Recipient's Rights | |
Recipient's Rights Notification | |
Financial Policy | |
Payment Contract for Services | |
Code of Ethics and Mission Statement | |
Therapist's Ethics Statement | |
Agreement Regarding Minors | |
Preauthorization for Health Care | |
Confidentiality Agreement | |
Forms Designed for HIPAA Compliance | |
Introduction | |
Privacy of Information Policies | |
Request to Amend Health Records | |
Request for Restricted Use/Disclosure of Records | |
Request for Alternative Means of Confidential Information | |
Release of Information Consent | |
Record of Requests for Client Information | |
Request for Listing of Disclosures of Client Records | |
Screening Information | |
Mental Health Screening Form | |
Substance Abuse Screening Form | |
Adaptive Functioning Screening Form | |
Learning Disability Screening Form | |
ADHD Screening Form | |
Assessment Forms | |
Introduction | |
Initial Assessment-Adult | |
Example of Completed Form | |
Initial Assessment-Children and Adolescents (<18) | |
Example of Completed Form | |
Personal History-Adult (18+) | |
Example of Completed Form | |
Personal History-Children and Adolescents (<18) | |
Example of Completed Form | |
Couple's Information Form | |
Emotional/Behavioral Assessment | |
Example of Completed Form | |
Emotional/Behavioral Update | |
Example of Completed Form | |
Diagnostic Assessment Report | |
Example of Completed Form | |
Diagnostic Assessment-Lower Functioning | |
Example of Completed Form | |
Biopsychosocial Report | |
Example of Completed Form | |
Psychological Evaluations | |
Introduction | |
Psychological Evaluation-Adult | |
Example of Completed Form | |
Psychological Evaluation-Children and Adolescents | |
Example of Completed Form | |
Psychological/Vocational Assessment | |
Neuropsychometric Consultation | |
Treatment Planning Forms and Procedures | |
Introduction | |
Individual Treatment Plan | |
Example of a Poor Treatment Plan | |
Example of Completed Form-Adult | |
Example of Completed Form-Children and Adolescents | |
Short-Term Therapy Treatment Plan | |
Example of Completed Form | |
Treatment Review | |
Example of Completed form | |
Treatment Update | |
Example of Completed Form | |
Progress Notes | |
Introduction | |
Progress Notes | |
Example of Poor Progress Notes | |
Example of Completed Form-Adult | |
Example of Competed Form-Children and Adolescents | |
Progress Notes-Outline | |
Example of Completed Form | |
Group Therapy Progress Notes | |
Example of Completed Form | |
Psychiatric Medication Management Progress Notes | |
Other Forms Used during the Course of Treatment | |
Introduction | |
Referral for Mental Health Services | |
Informed Consent for Medication | |
Suicide Contract | |
Cooperating in Child Rearing | |
Couple's Analysis of Target Behaviors | |
Example of Completed Form | |
Third-Party Prior Authorization Request for Continued Services | |
Example of Poor Authorization Request | |
Example of Completed Form | |
Chart Review and Outcomes Documentation | |
Introduction | |
Chart Review | |
Utilization Review Committee Guide to Review Charts for Audit | |
Utilization Review Committee-Chart Review Summary | |
Medical Records Audit Chart | |
Statement of Confidentiality for Those Auditing or Reviewing Client Charts | |
Outcome Survey for Adults | |
Outcome Survey for Children | |
Outcome Survey for Families and Relationship | |
Termination and Aftercare | |
Introduction | |
Discharge Summary | |
Example of Completed Form | |
Termination Letter | |
Bibliography and Suggested Readings | |
CD-ROM Table of Contents | |
About the CD-ROM | |
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